Background: Patients across various cancers who develop immune-related adverse events (irAEs) post-immune checkpoint inhibitor (ICI) treatment tend to experience better tumor response and survival than those who do not. However, studies regarding this association in patients with esophageal squamous cell carcinoma (ESCC) are limited. Methods: We assessed the relationship of irAEs with tumor response and survival in 82 consecutive patients with unresectable advanced or recurrent ESCC treated with second- or later-line nivolumab, an anti-PD-1 antibody, monotherapy. Results: We observed irAEs in 24 (29.3%) patients, with the overall response and disease control rates in the irAE-positive group being significantly better than those in the irAE-negative group (bothp< 0.0001). During the entire period and within 8 weeks of nivolumab initiation, progression-free and overall survivals (PFS and OS, respectively) were significantly better in patients with grade1/2 irAEs than in those without. Univariate and multivariate analyses indicated grade1/2 irAEs during the entire period and within 8 weeks as independent covariates for PFS (entire period: hazard ratio [HR] 0.28, 95% confidence interval [CI] 0.16–0.49,p< 0.001; within 8 weeks: HR 0.46, 95% CI 0.23–0.93,p= 0.03) and OS (entire period: HR 0.24, 95% CI 0.13–0.44,p< 0.001; within 8 weeks: HR 0.41, 95% CI 0.18–0.92,p= 0.03). Conclusions: Grade1/2 irAEs during the entire treatment period and within 8 weeks of nivolumab initiation were significantly associated with improved tumor response and survival in patients with advanced ESCC treated with nivolumab monotherapy. Therefore, mild irAEs may be predictive markers for the response and prognosis of ESCC following ICI treatment.
背景：在多种癌症患者中，接受免疫检查点抑制剂（ICI）治疗后出现免疫相关不良事件（irAEs）的患者，其肿瘤反应和生存情况往往优于未出现irAEs的患者。然而，关于食管鳞状细胞癌（ESCC）患者中此关联的研究尚有限。方法：我们评估了82例连续收治的不可切除晚期或复发性ESCC患者中，irAEs与肿瘤反应及生存的关系。这些患者均接受了二线或后线抗PD-1抗体纳武利尤单抗单药治疗。结果：24例（29.3%）患者观察到irAEs。irAE阳性组的总缓解率和疾病控制率均显著优于irAE阴性组（两者p < 0.0001）。在整个治疗期间及纳武利尤单抗治疗开始后8周内，出现1/2级irAEs患者的无进展生存期和总生存期（分别为PFS和OS）均显著优于未出现irAEs的患者。单变量和多变量分析表明，在整个治疗期间及治疗开始后8周内出现的1/2级irAEs是PFS（整个期间：风险比[HR] 0.28，95%置信区间[CI] 0.16–0.49，p < 0.001；8周内：HR 0.46，95% CI 0.23–0.93，p = 0.03）和OS（整个期间：HR 0.24，95% CI 0.13–0.44，p < 0.001；8周内：HR 0.41，95% CI 0.18–0.92，p = 0.03）的独立相关因素。结论：在接受纳武利尤单抗单药治疗的晚期ESCC患者中，整个治疗期间及治疗开始后8周内出现的1/2级irAEs与改善的肿瘤反应和生存显著相关。因此，轻度irAEs可能作为预测ESCC患者ICI治疗后反应和预后的标志物。
肿瘤(癌症)患者之家